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I wanted to just get into the pulse systems that acupuncture and many other eastern medical systems use for diagnosis, or sometimes just a part of diagnosis.
There are many levels and complexities of pulse diagnosis, and often people only know of the very basic pulse diagnosis, where you cannot really get much out of the pulse, so facial, tongue, and other diagnosis have to be carried out to help diagnose a problem.
There is one Daoist medical system which has a very advanced form of pulse diagnosis, that if you were to be good at it, you don’t have to do a lot of other diagnosis that you would in TCM (Traditional Chinese medicine).
The link here explains this system: http://www.acupuncture.com/education/diagnosis/pulsediag.htm
I will copy and paste some of the text and images below for easy reference:
Pulse Wave Energy Segments
AB qi Yang/yang function
BC qi Yin/yang function
CD xue Yin/yin capacity
DE xue Yang/yin capacity
The Normal pulse is often identified with the stomach energy because it is the organ which supplies nourishment and support for all others. Together with the spleen, the earth Phase absorbs, coordinates, and transforms; five elementally, it is at the center of the sine wave movement. The dampness or substantial quality sometimes attributed to its pulse character is indicative of that nurturing and supportive role. That central importance is emphasized in the seasonal 5-Phase scheme: each Phase communicates with the spleen before cycling to the next Phase in the shen cycle (9).In a perfectly healthy person, all the pulses would present this smooth, balanced sine wave movement connected at all positions and depths- -and it should be present during the entire year, not only in late summer. While the seasonal energy will have some influence in the pulses, emotions have a much stronger and immediate influence. The energy movements of the four seasons add their wave shapes to the patient’s energetic movement. The interactions of those two wave forms uniquely describe the patient’s reaction to the seasonal change.
The basic wave can be further analyzed by dividing it into its yang and yin components. The normal pulse begins with an ascending or yang movement. The convex portion indicates the yang energy or qi of the movement [ABC], while the concave portion describes the state of yin energy or blood of each organ [CDE]. To determine the balance within this movement, check the size, angles, and texture of the yang portion and compare it to the yin portion. Ideally, the yin and yang portions of each pulse should be symmetrical, hold the same capacity, and display the same textures. A sharper angle of ascent indicates that the pulse contains more yang energy or heat; a smoother angle indicates that yin is more prevalent. If the ascending movement is more prominent, the pulse will have a tendency to float; when the descending movement is more prominent it will have a tendency to sink (10). When the rising movement is dominant it can also have a tendency to be more superficial or express an acute syndrome. If it is a chronic condition the syndrome expressed will be light, superficial, or immediate.
If the pulse begins with a descending motion (the sine wave is reversed), the organ energy is reversing and, if more than one pulse position presents this reversal, the mother-son rule of the 5-Phase theory is breaking down and the condition is more critical.
Symptoms are created by contrasts in function, energy, or movement. The capacity of a pulse movement to create symptoms can be measured by the area of the yang [ABC] or yin [CDE] portion of the pulse. For example, if the yin portion of the pulse is larger, then the yin energy has the greater capacity to express a symptom. The pulse is not necessarily obliged to express this capacity, but we can see the potential for expression. And our diagnosis does not have to rely solely on the patient’s report of their symptoms; we can observe problems before the patient can be aware of them. This capability of pulse reading is essential in discriminating the root of the problem from the branch; as well as in cases where the patient has forgotten, is unaware, or is hiding aspects of the condition.
These elementary rules can be applied repeatedly as tools to analyze any pulse shape or energy. Taking the first half or yang portion as our focus, the movement going up is yang of yang while the second movement of the first half of the basic wave is yin of yang. In the yin portion of the basic wave, the movement descending is yin of yin; the movement ascending to the horizontal axis is yang of yin. The yang of yin portion connects to the next pulse position, feeding its yang of yang movement.
The clinical implications of this fourfold analysis are far-reaching (11). Let’s consider several examples of a Flooding (hong) pulse, which can, in general, indicate heat or bacterial inflammation. First, we need to keep in mind that when the upbeat is yang, it indicates the qi and when the downbeat is yin, it indicates blood. The ascending movement of a Flooding pulse can be smaller than the descending motion, or the rising motion can be larger than the descending motion. These two pulses offer us different information even though both are Flooding.
Both present bacterial inflammation with a certain range of fever or temperature. Where the downbeat is larger it indicates that the yin energy or blood is more influenced by the heat than the qi therefore we should expect more pus formation and lymphatic blockage. In the other example, heat affects the qi more, and we should expect a higher fever but less pus formation.
If we want to see if the heat expressed in the Flooding pulse is affecting the upper or the lower body, we can observe it the chi, guan, cun divisions. If the Flooding pulse is moving towards the cun it indicates that it is affecting the upper part of the body and if it is moving towards the chi it indicates that it is affecting the lower part of the body.
Consider the wave movement in the chi position of the right wrist, the large intestine. A pulse that rises in a normal sine curve but becomes wiry in the yin portion before it returns to the horizontal axis indicates that qi is not a problem but there is some problem in the yin or blood movement related to that organ. It may indicate that some heavier materials are stagnating and the organ itself is now being affected because that heavy material has not been eliminated. The organ does not have enough energy so elimination is impaired, building toward a toxic condition.
If the situation was reversed and the upbeat was wiry and the downbeat was normal, it would indicate that the large intestine itself is affected energetically and not able to handle routine material. The organ itself is the problem rather than the material that the organ is managing. The difference between these two conditions can be illustrated by a person trying to lift a box who cannot do it. There are two possible reasons: either the person is too weak or the box is too heavy. If the downbeat is the problem, it indicates that the box is too heavy; if the upbeat is the problem, it indicates that the person trying to lift it is too weak.
Floating (fu) & Sinking (chen)
Floating and Sinking refer to the movement on the vertical axis of symmetry independent of the horizontal. The Floating pulse is found at the superficial level and the sinking pulse in the deep level. Generally, the Floating pulse indicates yang excessiveness due to wind or heat, and the Sinking pulse indicates yin excessiveness due to cold energy. Floating and Sinking refer primarily to the depth at which the pulse is found. Floating and Sinking can also refer to the direction the energy is moving along the vertical axis, even when found at different pulse depths or sectors. We may sense degrees of a Floating or Sinking state as a stronger yang of yang movement or yin of yin movement.
Rapid (shuo) & Slow (chi)
Rapid and Slow refer to movement alone the horizontal axis of symmetry and the speed of the pulse movement when compared to the patient’s breathing. The normal or balanced pulse is four beats per breath. A Rapid pulse is more than 4 beats per breath. A Slow pulse is less than 2 beats per breath. A pulse can become Rapid due to a “deficiency of yin and an excess of yang” energy. The Slow pulse results from “a deficiency of yang and an excess of yin”(22). In general, the Slow pulse indicates cold energy and Rapid pulse indicates hot energy. If the pulse moves faster than 6 beats or slower than 2 it is an extremely critical sign, usually indicative of death; yang and yin no longer communicate with each other and are about to be cut.
When the pulse is excessively fast, the energy will be cut at the chi position, move towards the cun, and finally disappear. When the pulse is excessively slow, the energy will cut off at the cun position and move towards the chi and finally disappear. For these two examples simply compare the energy of someone who just came out of a sauna and is about to faint from the heat to someone who was exposed to freezing weather and is about to pass out.
When the pulses are slow in comparison to the rate of breathing, we can say that the patient does not have sufficient yang energy or that his interior can be cold or damp. The Rapid pulse indicates that there is too much heat, that the condition is affecting the upper warmer, or that it is taking place at the surface. It could be excessiveness or it could be a condition caused by an attack of perverse energy, etc. Heat in the interior, for example near the bone, will be found in the deep level but will present a rapid movement. A slow movement at the superficial level indicates cold energy invading at the surface of the body.
Big & Small, Long (chang) & Short (duan)
Big and Small refer to the vertical dimension of the wave form, its amplitude. In general they indicate the amount of active qi available at a given moment. Long and Short refer to the horizontal dimension of the wave, its frequency. These pulses indicate the capacity of the related organs, and are often related to the hot and cold energy balance. Big and Long pulses indicate that the qi flow is greater than the blood flow, while the Small and Short pulses indicate that the blood flow is greater than the qi flow.
The horizontal dimension of the pulse wave indicates what the capacity the wave form holds. Compare the vertical movement to voltage and the horizontal to wattage. So if it is Big and Long it means that the output is strong, but if it is Small and Short it means that the output is diminished but the movement can still last for an extended period of time. When the pulse is Small it means that it will not last because it does not have enough energy support to continue. Endurance or the capacity of a particular stress, that is how long it will last, depends on the horizontal movement.
Slippery (hua) & Choppy (se)
These two states describe specific textures of the pulse wave and not necessarily the shape itself. The previous pulse states show a yang/yin scale in specific dimensions, these two pulse states are a comparison between the qi and blood and illustrate the relationship of qi within the blood and the blood within the qi–similar to the portion of the Tai Chi symbol which shows yang within yin, and yin within yang.
The Slippery pulse feels “round and smooth and flows evenly”(13). The sensation is like touching oil or wet and hard beads, it curves evenly up and then back down. In general it indicates dampness or that qi is deficient in comparison to blood. Li Shi Zhen comments (14) that a Slippery pulse can be created when yuan qi fails “and is unable to hold liver and kidney fire.” Typically you can expect mucus secretion or, if it is the dominant character, a blockage to the blood flow with very low qi movement. You will commonly verify a mucus problem by looking at the spleen’s relationship to the other involved organs. It can be found in women during pregnancy; and, if over forty, it will be evident in the menopause pattern.
The Choppy pulse feels “thin, minute, and short and has an uneven flow, beating three and five times with an irregular rhythm.” It is often described as feeling like touching very fine sandpaper or a “knife scraping bamboo”(15). In terms of our Tai Chi model, the horizontal movement of the qi is not supported by the yin energy. Like the knife, the momentum pushes forward but is carried in a jerky motion. In general, it feels very thin and irregular, making it sometimes difficult to flow. It indicates a dry condition, where qi is more abundant then blood. It can often be observed in anemic patients and in those recovering from surgery because of blood loss.
Knotted (jie)
A Knotted pulse is an indication of excessive yin- -“whenever excessive perverse yin qi coagulates”(l6). A Knotting pulse does not always occur every pulsation and can appear irregularly. It indicates energy blockages, mucus blocks, moving clots, cysts, tumors, and even cancer. This pulse tends to hold the peak for a prolonged period of time and then drop, or hold the bottom and go up without a pronounced peak.
As a general rule, we know that a deficiency of yin will lead to an excess of yang. If yin energy becomes deficient, the pulse will not be able to connect to the deep level. This will be compensated by the further growth of Yang energy or further strengthening of the upbeat. But since the yang movement cannot go beyond the top level, which is superficial, it will compensate by a build up intensity at that level. As the yin energy becomes more and more deficient, the strength of the yang upbeat will bud correspondingly, manifesting in a Knotted pulse with a pronounced peak. If the energy is Knotting in every pulsation, it is more serious and might indicate cancer. In this last case, it shows a severe loss of stability of the Tai Chi equilibrium.
If this pulse shows up between two pulse waves as an independent movement, then it could be an early sign of cancer, even though it is not clearly Knotting in the organic wave. In some cancer movements, the pulse can be felt to rise and actually knot or vibrate in situ: without a descending movement. This Knotted state– as well as others which we will look at later–is usually picked up in the top or bottom of each pulsation but they can occur in other levels of each wave as well.
Awesome share if your looking to learn pulse @amina
Oh this kind of explains like what happens when I use to get sick(Hangover) and my heart beat feels off…even though it was beating a lot.
Then I’d have to do a certain deep breathing routine and compress and the heart beat would deepen.Cool
so complicated, i would love to get a lecture about this with you, Z. Let me know if you ever teach more classes on pulse diagnosis.
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